Today Health Insurance Policy has become an important need of every person. The cost of treatment has increased a lot. People have also started falling prey to diseases.
In such a situation, both the importance and necessity of health insurance policy have become more than before. If you also want to take an insurance policy, then before taking the policy, you must understand the terms and conditions and insurance terminology. If you do not do this, you will not be able to take full advantage of the policy.
Sub limit is also one such rule, which is very important to know. Most of the people do not take information about the sub limit while taking the policy and then repent at the time of claim settlement.
Sub-limit is a cap on the amount of coverage provided in an insurance policy. Obviously this cap is expressed as a fixed amount in the policy. Sub-limits are placed for certain diseases or treatments as well as for certain services. Sometimes the sub limit is shown as a percentage of the sum assured and sometimes it is mentioned as a fixed amount.
Understand the fund of sub limit in this way
Suppose that the sum insured of your policy is 5 lakhs. But the policy has kept a sub-limit for the treatment of any disease. If the sub limit is Rs.50,000 and your expenditure on treatment of illness has gone up to Rs.100,000. In this situation the insurance company will pay only Rs 50,000. Because in the policy he had already mentioned the sub limit for the treatment of that disease. Now even though the sum assured of your policy is Rs 5 lakh, but due to the sub limit, you will have to pay the remaining Rs 50,000 from your pocket.
Sub limits on services also
Insurance companies keep sub limits not only on diseases but also on some services. Usually it is applicable on many services including hospital room rent, ICU charges, ambulance fees or OPD fees.
For example, the insurance company can keep a condition on the rent of the hospital room keeping the sub-limit that it will pay only Rs.3000 per day as rent. If you take such a room in the hospital, whose rent is 5 thousand rupees, then you will have to pay the above two thousand rupees from your pocket.
The sub limit can also be in percentage of the Sum Assured. Suppose your sum insured is Rs.5 lakhs and the room rent sub limit is 2% of the sum insured, then you can claim up to Rs.10,000 as room rent. Not more than this. Even if your policy is of 5 lakh rupees.
Must understand that
before taking an insurance policy, you should take information about all the sub-limits included in it. You should choose such a policy, in which all the limits are low. Generally, the premium for a policy with a higher sub limit is lower. We take them because of the low premium. When it comes to paying the bills in the hospital, then we come to know that we have made a mistake.
